Provider Demographics
NPI:1275171753
Name:SAINT GEMMA HEALTH AND WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:SAINT GEMMA HEALTH AND WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT (BOARD PRESIDENT)
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FALLAVOLLITA
Authorized Official - Suffix:
Authorized Official - Credentials:MS MED, LMHC
Authorized Official - Phone:978-518-0674
Mailing Address - Street 1:C/O MARY FALLAVOLLITA
Mailing Address - Street 2:375 MAIN ST.
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830
Mailing Address - Country:US
Mailing Address - Phone:978-518-0674
Mailing Address - Fax:978-658-5728
Practice Address - Street 1:C/O MARY FALLAVOLLITA
Practice Address - Street 2:375 MAIN ST.
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-518-0674
Practice Address - Fax:978-658-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health